Prognostic value of preoperative dynamic contrast-enhanced magnetic resonance imaging in epithelial ovarian cancer

Lindgren, Auni; Anttila, Markku; Arponen, Otso; Rautiainen, Suvi; Könönen, Mervi; Vanninen, Ritva; Sallinen, Hanna

doi:10.1016/j.ejrad.2019.03.023

Cited by 19 publications

(10 citation statements)

References 37 publications

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“…Yang et al (38) and Mayr et al (39) showed that DCE-MRI parameters derived from low-enhancement or poorly perfused areas were associated with poor post-treatment outcomes in cervical cancer, which is consistent with our findings. Lindgren et al (20) showed that the lower mean K trans value was correlated with the higher risk of residual tumor after cytoreductive surgery, which also support our results. In addition, studies had proven that other histogram parameters (SD, skewness, and 95th percentile) of K trans were helpful for differential diagnosis and the prediction of prognoses, which further confirmed the advantage of DCE-MRI histogram analysis in reflecting tumor heterogeneity (29,40,41).…”

Section: Discussionsupporting

confidence: 91%

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Whole solid tumor volume histogram parameters for predicting the recurrence in patients with epithelial ovarian carcinoma: a feasibility study on quantitative DCE-MRI

Tang

Feng

et al. 2020

Acta Radiol

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Background Preoperative prediction of the recurrence of epithelial ovarian carcinoma (EOC) can guide the clinical treatment and improve the prognosis. However, there are still no reliable predictive biomarkers. Purpose To evaluate whether whole solid tumor volume histogram parameters measured from quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can predict the recurrence in patients with EOC. Material and Methods We followed up 56 patients with surgical and histopathologically diagnosed EOC who underwent quantitative DCE-MRI scans. The differences of the histogram parameters between patients with and without recurrence were compared. Mann–Whitney U test, Pearson’s Chi-squared test, or Fisher’s exact test, and receiver operating characteristic (ROC) curves were used for statistical analysis. Results All histogram parameters of Ktrans, kep, and ve were not significantly different between EOC patients with and without recurrence ( P>0.05). For 30 patients with high-grade serous ovarian carcinoma (HGSOC), the histogram parameters of Ktrans (mean and 5th, 10th, 25th, 50th, 75th percentiles) and kep (mean and 50th percentile) in 12 patients with recurrence were significantly lower than those in 18 patients without recurrence (all P<0.05). ROC curves showed that the 5th percentile of Ktrans had the largest area under the curve (AUC) of 0.792 for predicting the recurrence in patients with HGSOC. When the threshold value was ≤0.0263/min, the sensitivity, specificity, and accuracy were 100%, 66.7%, and 80%, respectively. Conclusion Instead of predicting the recurrence of EOC, whole solid tumor volume quantitative DCE-MRI histogram parameters could predict the recurrence of HGSOC and may be potential biomarkers for the prediction of HGSOC recurrence.

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Section: Discussionsupporting

confidence: 91%

“…Recently, the study by Lindgren et al. (20) showed DCE-MRI parameters can predict the clinical outcome in ovarian cancer by measuring simple mean values. To our knowledge, there have been no studies on DCE-MRI histogram analysis to predict EOC recurrence.…”

Section: Introductionmentioning

confidence: 99%

Whole solid tumor volume histogram parameters for predicting the recurrence in patients with epithelial ovarian carcinoma: a feasibility study on quantitative DCE-MRI

Tang

Feng

et al. 2020

Acta Radiol

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“…In unclear cases a senior radiologist (SR) with 12 years of experience in gynecological imaging was available for consultation. Image analysis has been described in detail previously [22]. The perfusion parameter maps were generated automatically with NordicICE using pharmacokinetic modeling of contrast kinetics according to the Tofts model [28].…”

Section: Methodsmentioning

confidence: 99%

“…Conventional magnetic resonance imaging (MRI) is applied in the preoperative imaging of indeterminate ovarian tumors due to its superior soft tissue extraction. Dynamic contrast enhanced (DCE) sequence, utilizing contrast agent extravasation from blood flow to tissues, may not only be used to characterize benign lesions from malignant tumors [19,20] but may also provide additional information on the tumor prognosis [21,22] and treatment response [23–25]. Pharmacokinetic perfusion parameters reflect the circulation physiology in the microvasculature and give quantitative parameters to compare flow and vessels permeability properties [26–28].…”

Section: Introductionmentioning

confidence: 99%

Dynamic contrast-enhanced perfusion parameters in ovarian cancer: Good accuracy in identifying high HIF-1α expression

et al. 2019

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Background Hypoxia significantly influences treatment response and clinical outcome in solid tumors. A noninvasive marker for hypoxia will help physicians in treatment planning and encourage the efficient use of hypoxia targeted therapies. The purpose of this study was to investigate whether pharmacokinetic dynamic contrast-enhanced (DCE) perfusion parameters are associated with a specific marker of hypoxia, hypoxia-inducible factor 1 alpha (HIF-1α) in ovarian cancer (OC). Materials and methods Thirty-eight patients with primary OC were enrolled in this prospective study approved by the local ethical committee. Patients underwent dynamic gadolinium-enhanced 3.0 T MRI as part of their staging investigations. Pharmacokinetic perfusion parameters, including a rate constant for transfer of contrast agent from plasma to extravascular extracellular space (EES) (K trans ) and a rate constant from EES to plasma (K ep ), were measured by drawing two types of regions of interest (ROIs): a large solid lesion (L-ROI) and a solid, most enhancing small area (S-ROI) (NordicICE platform). Tissue samples for immunohistochemical analysis were collected during surgery. Kruskal–Wallis, Mann–Whitney U and Chi-square tests were used in statistical analyses. Receiver Operating Characteristic curve analyzes were done for DCE parameters to discriminate high HIF-1α expression. Results Pharmacokinetic perfusion parameters K trans and K ep were inversely associated with HIF-1α expression (K trans L-ROI P = 0.021; K trans S-ROI P = 0.018 and K ep L-ROI P = 0.032; K ep S-ROI P = 0.033). K trans and K ep showed good accuracy in identifying high HIF-1α expression (AUC = 0.832 K trans L-ROI; 0.840 K trans S-ROI; 0.808 K ep L-ROI and 0.808 K ep L-ROI). Conclusion This preliminary study demonstrated that pharmacokinetic DCE-MRI perfusion parameters are associated with the hypoxia specific marker, HIF-1α in OC. DCE-MRI may be a useful supplementary tool in the characterization of OC tumors in a staging investigation.

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“…BRCA mutations are present in approximately 14% of epithelial ovarian cancers. The poor mortality of this illness is attributable to diagnosis made at the terminal stage, accounting for approximately 70% of the total ovarian malignancies [2,3]. Contemporary research suggests that every histologic type of EOC is related to different morphologic and molecular mutations, such as endometroid, clear-cell, mucinous, and serous carcinomas [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

MicroRNA-145-5p regulates the proliferation of epithelial ovarian cancer cells via targeting SMAD4

Zhou¹,

Zhang²,

Li³

et al. 2020

J Ovarian Res

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Background: Epithelial ovarian cancer (EOC) is one of the most prevalent malignancies affecting females worldwide; however, its etiology mechanism remains unclear. In various malignancies, miR-145-5p is a widely accepted and versatile miRNA. Therefore, our research focused on exploring the activity and etiology of miR-145-5p in the modulation of metastasis, migration, and proliferation of EOC cells. The direct reactions between the 3′UTRs of SMAD4 mRNA and miR-145-5p were verified using dual luciferase reporter test. SKOV-3 cells were subsequently transfected using miR-145-5p mimics. Cell migration, death, and proliferation were evaluated using MTT, flow cytometry, and Transwell test. In addition, SMAD4 transcription and translation were evaluated using qRT-PCR and Western blot. Results: We found that miR-145-5p expression was repressed prevalently in EOC tissues, apart from SMAD4 upregulation. Excessive miR-145-5p expression remarkably reinforced EOC cell death and repressed EOC cell proliferation. Furthermore, upregulated miR-145-5p expression noticeably repressed migration via MMP-2 and MMP-9 downregulation. Moreover, SMAD4 was downregulated via miR-145-5p transfection. The dual luciferase test revealed that miR-145-5p directly targeted SMAD4. Conclusions: Our research suggests that miR-145-5p serves as a malignancy repressor and exerts an essential impact on inhibiting malignancy generation and reinforcing EOC death via targeting SMAD4. MiR-145-5p application could serve as a promising strategy to treat EOC.

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Prognostic value of preoperative dynamic contrast-enhanced magnetic resonance imaging in epithelial ovarian cancer

Abstract:  Mean K trans values were higher in high-grade serous OC than in other types  Lower mean K trans values predicted residual tumor in sytoreductive surgery  Multiparametric MRI variables were predictive for recurrence free survival

Cited by 19 publications

References 37 publications

Whole solid tumor volume histogram parameters for predicting the recurrence in patients with epithelial ovarian carcinoma: a feasibility study on quantitative DCE-MRI

Whole solid tumor volume histogram parameters for predicting the recurrence in patients with epithelial ovarian carcinoma: a feasibility study on quantitative DCE-MRI

Dynamic contrast-enhanced perfusion parameters in ovarian cancer: Good accuracy in identifying high HIF-1α expression

MicroRNA-145-5p regulates the proliferation of epithelial ovarian cancer cells via targeting SMAD4

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